Adrenal gland dysfunction has long been implicated in the pathogenesis of various human hypertensive states. Excessive production of several specific 11-deoxy corticosteroids have also been reported in some patients with essential hypertension (EH) both with and without low plasma renin activities. In a prior study, we demonstrated that both low and normal renin EH patients differed from normotensive controls in their plasma levels of several ACTH-dependent steroids during the infusion of pharmacologic quantities of ACTH by a pattern which suggested a functional impairment of adrenal 11 and 17 hydroxyating steps. We propose to extend and refine this previous study by examining the plasma levels of aldosterone, 11-deoxycorticosterone, corticosterone, 11-deoxycortisol and cortisol (and possibly 18 OH DOC) in adolescent "prehypertensive" and adult hypertensive patients after incremental graded infusions of ACTH during endogenous ACTH suppression - a technique that duplicates the physiologic range of in vivo ACTH levels. We will study: a) young adult males from Bourbon County, Ky. - an area with a high prevalence of hypertension - from the 10th and 90th percentiles of systolic blood pressure for their age and race; and b) adult patients with established low and normal renin EH and matched adult normotensive controls. We hope to determine whether abnormal patterns of adrenal steroid biosynthesis are detectable in these prehypertensive and hypertensive patients. The demonstration of altered adrenal steroid synthesis in such subjects would suggest that adrenocortical dysfunction might contribute to the pathogenesis of essential hypertension, and could provide a basis for innovative pharmacologic approaches to the treatment of this disease.